摘要
目的：探究行急诊手术治疗的急性肠梗阻患者术后切口感染病原菌和相关危险因素，为降低临床急性肠梗阻急诊手术感染率、改善患者预后提供参考。方法选取2010－08-2014－08我院收治的行急诊手术治疗的急性肠梗阻患者216例，依据患者术后切口是否感染将患者分为感染组（43例）和对照组（173例）。取感染组患者切口脓性分泌物进行病原学检测；收集患者的基本资料，采用Logistic回归法分析行急诊手术治疗的急性肠梗阻患者术后切口感染相关危险因素。结果43例急诊手术术后感染患者共发现16株细菌，主要致病菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和粪肠球菌，且患者存在细菌交叉感染现象；年龄≥60岁、BMI≥28 kg／m2、血运性肠梗阻、伴糖尿病、夏季行急诊手术、Ⅲ类手术切口和手术时间＞120 min的患者是急性肠梗阻术后切口感染的相关危险人群。结论高度警惕行急诊手术治疗急性肠梗阻术后切口感染的高危人群，对这类患者加强抗感染预防治疗，以降低临床感染率，提高患者预后。
Objective To explore the pathogenic bacteria and correlation factors for incision infections of emergency surgery in patients with acute ileus, in order to decrease the clinical infection rate and improve patients＇prognosis.Methods Two hundred and sixteen patients with acute ileus who had emergency surgery were surveyed from August 2010 to August 2014 in our hospital.They were divided into the infection group with 43 cases and the control group with 173 cases according to whether had been infected after emergency surgery.The etiology of purulent secretion in the infection group patients＇incisions was detected.The correlation factors for incision infections of emergency surgery in patients with acute ileus were analyzed by logistic method.Results There were 16 strains of bacteria had been detected in the 43 infected patients after emergency surgery.The main etiologies were escherichia coli, klebsiella pneumonia, pseudomonas aeruginosa, staphylococcus aureus and enterococcus faecalis.Co-infection phenomenon was present in the infected patients with acute ileus who had emergency surgery.Elder than 60 years, BMI more than 28, patients with obstruction of vascular supply origin, companied with diabetes, and had emergency surgery at summer, with type Ⅲincision and more than 120 minutes operation were the correlation factors for incision infections of emergency surgery in patients with acute ileus.Conclusion The high risk patients with acute ileus who had treated with emergency surgery should catch more attentions.The strengthened prevention measures should be applied to decrease the clinical infection rate and improve patients＇prognosis.
出处
《中国急救医学》
CAS
CSCD
北大核心
2015年第3期259-261,共3页
Chinese Journal of Critical Care Medicine
关键词
急诊手术
急性肠梗阻
切口感染
病原菌
危险因素
Emergency surgery
Acute ileus
Incision infection
Pathogenic bacteria
Risk factors
作者简介
董磊（1978-），男，主治医师。
